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Hearing Loss After Tube Insertion
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yankee100 posted:
I had a tube inserted in one ear because I was going to be flying and I had a lot of pressure in my ear. I suffer from many food allergies and my sinuses are usually inflamed. I did not have any fluid in the ear. After taking prednisone for 6 days the sinus inflammation seemed to be better, but the ear was diagnosed as ETD. Since the tube insertion I have a feeling of fullnes that comes and goes, constant noise that sounds like a hissing, which also gets louder or lower but never ceases, and I was diagnosed with nerve damage that can never be restored resulting in a hearing loss.

It has been just about a month now. I can accept the hearing loss, but I'm wondering if the hissing and fullness will ever go away. It seems when I take Claritin D and Ibuprofen the symptoms aren't as bad, although they still don't totally go away. My doc is now wanting to do balloon sinuplasty for my sinuses. He seems to want to move on from the ear problems to the sinus situation. I don't want any complications from that procedure, so I am starting to consider not doing that. I have had an MRI and CAT scan and everything is normal.

I have read on this site about people with nerve damage that get shots and the hearing is somewhat restored. My ENT says once you have nerved damage that's it. Nothing will restore it.

Do you think I need more time for the hissing and fullness to abate. It's been one month.

Thanks for taking the time to answer questions on this site. It's been very helpful.
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Rod Moser, PA, PhD responded:
Without knowing the medical details of your case, including your examination findngs and test results, I really would have no way of even guessing how long your tinnitus might last. Tinnitus due to middle ear issues, or after the insertion of tubes can last variable lengths of time depending on the severity of your underlying problem. There is no way to even guess. If your tinnitus is due to inner ear or a central cause (brain), then the tinnitus could last a lifetime. Again, I don't know.

Based on your reluctance to have further surgery and the fact that your ear procedure results were not optimum, considering a second opinion from another ENT would seem appropriate -- someone who can examine you, review your test results, and see if your first ENT's diagnosis and plan is accurate.
 
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yankee100 replied to Rod Moser, PA, PhD's response:
Thanks for your reply. After reading the other discussion on tube insertion problems I am confused as to why people experience the fullness feeling, noise issues and other symptoms. Is it because of the trauma to the eardrum? The most puzzling question to me is why the symptoms vary so much over periods of time.....ringing increases or decreases.....fullness comes and goes. If there is trauma to the eardrum I would think it is either slowly getting better, which explains the variations, or staying the same and not fluctuating from good to bad to worse and back to good. Is there an explanation for this, or maybe it's just happening to me. It's been about a month for me since I've had the tube put in . The noise has changed several times and the fullness seems to not always be present, but it's not gone either.

Thanks for your input.
 
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Rod Moser, PA, PhD replied to yankee100's response:
First....every person is different, and to a less-extent, every surgical procedure to insert the tubes can be a bit different (even tubes can be different). In medicine, we never expect or see universal results. With that said....

Inflammation is often the underlying culprit, and each person can mount a different inflammatory response. Until the swelling and inflammation completely resolves, you may experience fluctuating symptoms.

Tubes can clog....permanently or temporarily. This is due to drainage of middle ear fluid, dried blood, pus, or ear wax. Sometimes, the clog will "unclog" on its own; sometimes it will not. When the tubes are "open", you may experience that odd noise or echo; if it is clog, you may experience fullness or pressure again.

Since neither one of us can look in your ears to see exactly what is happening, you will need to rely on your ENT for patient specific advice. Are you on any antibiotic/steroid ear drops?
 
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yankee100 replied to Rod Moser, PA, PhD's response:
No, I am not on any kind of ear drops. It's been about 6 weeks now since I've had the tube in. I feel as if the swelling has gone down somewhat, but I still have the ringing which I am assuming is from the nerve damage. The strangest thing is when I shake my head up and down I hear can hear what seems to be air trapped in my ear. It almost sounds like when you are on a plane and your ear clogs. When you blow or hold your nose to clear the ear it feels as if air rushes through and unpops the ear. Why would this happen on the tube side when I shake my head. The audiologist could not do pressure tests on that side since I have the tube.

Did I read somewhere on one of your posts that you can get hearing aids to get rid of the static/ringing noise? I can deal with the mild hearing loss, but the noise is so annoying.
 
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Rod Moser, PA, PhD replied to yankee100's response:
See your ENT again. Tubes can clog, and often they even need to be replaced if they are not functioning correctly.

Yes, your tinnitus could be from nerve damage, but before jumping to hearing aids to try and mask the aberrant noise, see the ENT first for patient-specific advice.

I have had tinnitus for well over a dozen years now....
 
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yankee100 replied to Rod Moser, PA, PhD's response:
Thanks for the reply. My ENT feels as if the tinnitus isn't related to the tube. He says there is really nothing he can do about that and he doesn't know the cause. I think it's strange that the tinnitus started with the sinus infection, before the tube was placed. The nerve damage, hearing loss, and tinnitus all happened together. I don't really know when. I am guessing that sometime right before the sinus episode, and it was masked by the sinus inflammation. There was no fluid in the ear when the tube was placed.
My family doctor put me on prednisone which must have cleared up the fluid and some sinus inflammation. I then went to the ENT because of the ringing, fullness, etc. He put the tube in so I could fly. He thought I had ETD. The ENT believes a virus migrated or it's from an old blow to the head...which I have never experienced.
His main objective now is to do the balloon procedure which I am not really interested in. Yes, from the CAT SCAN my sinuses appear to be all gray and supposedly need to be opened up, but taking Claritin D and using Flonase seems to be working where I feel no pressure or pain. Would opening the sinuses up have anything to do with helping the tinnitus? According to my ENT none of these procedures have any lasting side effects. You just get up and go. After all of the problems with the tube, I am not looking for any suprises from the balloon procedure. I guess that's why I am hesitant to have it done.

It seems as if most concur that tinnitus is a medical mystery, and there is no fix for it. That's why I was thinking of going the route of the hearing aid to mask the sound. The worst time for the tinnitus is when I am trying to watch t.v.. It gets very tinny sounding and seems to be louder. During the day when I am busy and there are other noises around it isn't as bothersome.

So, your advice would be to skip the hearing aid for that problem?
 
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Rod Moser, PA, PhD replied to yankee100's response:
You need to consider getting a second opinion from an another ENT. Not that your current ENT could be wrong, but two heads are usually better than one when there is a challenging and difficult case, like yours. A high-level evaluation at a large, university-based medical center ENT department would be a good way to go. The collaborative resources at these large research and teaching instiutions may be very helpful to you. You will need to gather your records, scans, etc.
 
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yankee100 replied to Rod Moser, PA, PhD's response:
I have been thinking about a second opinion. I am in Houston, Tx and I believe my ENT is also affiliated with UT. He has also been voted as one of the top ENT by his peers for several years.

I was actually thinking of going the other route. Maybe an ENT with a smaller practice that would start from the beginning. I feel as if the other doctor has just run out of options, or really isn't paying as much attention to my case as he should.

Thanks
 
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Rod Moser, PA, PhD replied to yankee100's response:
Let me know how things turn out for you. Medicine (or surgery) cannot cure everything, but you have the right and responsibility to get as much input as you can to determine the best course of treatment for yourself.
 
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yankee100 replied to Rod Moser, PA, PhD's response:
Thanks Doctor Moser. I will keep you posted.


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